STRategies to manage Emergency ambulance Telephone Callers with sustained High needs: an Evaluation using linked Data (STRETCHED) - a study protocol.

Autor:	Aslam RW; Swansea University Medical School, Swansea University, Swansea, Wales, UK r.w.aslam@swansea.ac.uk., Snooks H; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Porter A; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Khanom A; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Cole R; West Midlands Ambulance Service NHS Foundation Trust, Brierley Hill, UK., Edwards A; Division of Population Medicine, Cardiff University, Cardiff, Wales, UK., Edwards B; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Evans BA; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Foster T; East of England Ambulance Service NHS Trust, Melbourn, UK., Fothergill R; London Ambulance Service NHS Trust, London, UK., Gripper P; Swansea University Medical School, Swansea University, Swansea, Wales, UK., John A; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Petterson R; Welsh Ambulance Services NHS Trust, Saint Asaph, UK., Rosser A; West Midlands Ambulance Service NHS Foundation Trust, Brierley Hill, UK., Tee A; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Sewell B; College of Human and Health Sciences, Swansea University, Swansea, UK., Hughes H; Swansea University Medical School, Swansea University, Swansea, Wales, UK., Phillips C; College of Human and Health Sciences, Swansea University, Swansea, UK., Rees N; Pre-Hospital Emergency Research Unit, Welsh Ambulance Service NHS Trust, Swansea, UK., Scott J; Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK., Watkins A; Swansea University Medical School, Swansea University, Swansea, Wales, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Mar 29; Vol. 12 (3), pp. e053123. Date of Electronic Publication: 2022 Mar 29.
DOI:	10.1136/bmjopen-2021-053123
Abstrakt:	Introduction: UK ambulance services have identified a concern with high users of the 999 service and have set up 'frequent callers' services, ranging from within-service management to cross-sectoral multidisciplinary case management approaches. There is little evidence about how to address the needs of this patient group. Aim: To evaluate effectiveness, safety and efficiency of case management approaches to the care of people who frequently call the emergency ambulance service, and gain an understanding of barriers and facilitators to implementation. Objectives: (1) Develop an understanding of predicted mechanisms of change to underpin evaluation. (2) Describe epidemiology of sustained high users of 999 services. (3) Evaluate case management approaches to the care of people who call the 999 ambulance service frequently in terms of: (i) Further emergency contacts (999, emergency department, emergency admissions to hospital) (ii) Effects on other services (iii) Adverse events (deaths, injuries, serious medical emergencies and police arrests) (iv) Costs of intervention and care (v) Patient experience of care. (4) Identify challenges and opportunities associated with using case management models, including features associated with success, and develop theories about how case management works in this population. Methods and Analysis: We will conduct a multisite mixed-methods evaluation of case management for people who use ambulance services frequently by using anonymised linked routine data outcomes in a 'natural experiment' cohort design, in four regional ambulance services. We will conduct interviews and focus groups with service users, commissioners and emergency and non-acute care providers. The planned start and end dates of the study are 1 April 2019 and 1 September 2022, respectively ETHICS AND DISSEMINATION: The study received approval from the UK Health Research Authority (Confidentiality Advisory Group reference number: 19/CAG/0195; research ethics committee reference number: 19/WA/0216).We will collate feedback from our Lived Experience Advisory Panel, the Frequent Caller National Network and Research Management Group for targeted dissemination activities. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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